Chronic Non-Communicable Diseases and Catastrophic Health Expenditure: Evidence from Indonesia

Presenter: Afanin Husna (UNAIR)

The purpose of this study is empirically investigating the incidence of chronic non-communicable diseases (NCDs) among household in Indonesia. NCDs include high blood pressure, diabetes, stroke and other diseases. NCDs reported significantly increase among household member in Indonesia, and it is potentially suffered by the younger and productive family member. WHO reported that NCDs is highly correlated with individual life style, such as less physical activity and dietary habit.  Long period of illness potentially put burden on family expenditure. Furthermore, this study focus on analyzing health expenditure among family with NCDs and without NCDs. High health expenditure potentially put household in catastrophic health expenditure (CHE). Imperfect health financing system, poor household with CHE might have to sacrifice other expenditure in respond to health condition.

Data and Methodology This study utilizes micro, i.e. individual and household data of Indonesia Family Life Survey (IFLS) wave 2007 and 2014.  IFLS is not only rich and nationwide coverage data but also a good laboratory to investigate CHE incident, as up to 2014 Indonesia Universal Health Coverage (UHC) System was not yet fully implemented. IFLS data is analyzed with Pooled Cross Section regression.

Preliminary Result and Policy Recommendation Preliminary result indicates that: (i) symptom of illness and NCDs are more occurrence among lower quintile income compare to their counterpart; (ii) NCDs does not associate with income and education level; and (iii) the higher CHE degree (15-40%) put further pressure on food and health expenditure among poorer household.  Chronic and NCDs such as high blood pressure, diabetes and stroke becoming more prevalence recently, and this condition has further consequence not only on family welfare but also burden on national health system coverage. To encourage better health production among family member, it is essential to justify the health system that in the future health insurance coverage i.e. BPJS only cover non habitual risk related diseases. Illness due to high risk habits such as lung cancer among smoker and diabetes should be less covered. This policy not only put less burden on government budget but also encourage individual to aware on health risk related behavior.